The discovery that all mental diseases are brain diseases would mean the disappearance of psychiatry into neurology.
No behavior or misbehavior is a disease or can be a disease. There is no mental disease. Period.
I don’t deny the existence of brain diseases; on the contrary, my point is that if mental illnesses are brain diseases, we ought to call them brain diseases and treat them as brain diseases—and not call them mental illnesses and treat them as such. In the 19th century, madhouses were full of people who were ‘crazy’; more than half of them, as it turned out, had brain diseases—mainly neurosyphilis, or brain injuries, intoxications, or infections. Once that was understood, neurosyphilis ceased to be a mental illness and became a brain disease. The same thing happened with epilepsy.
There is no blood or other biological test to ascertain the presence or absence of a mental illness, as there is for most bodily diseases. If such a test were developed (for what, theretofore, had been considered a psychiatric illness), then the condition would cease to be a mental illness and would be classified, instead, as a symptom of a bodily disease.
If we are to consider mental disease to be like physical disease, we ought to have biochemical or pathological evidence.” And if an “illness” is to be “scientifically meaningful, it must somehow be capable of being approached, measured or tested in a scientific fashion, as through a blood test or an electroencephalograph. If it cannot be so measured—as is the case [with]…’mental illness’—then the phrase ‘illness’ is at best a metaphor and at worst a myth, and that therefore ‘treating’ these ‘illnesses’ is an equally amorphous and unscientific enterprise.
On television, everything can now be a psychiatric ‘illness’ as long as there are psychiatrists willing to ‘diagnose’ and ‘treat’ it…[they] invariably label the behaviors as ‘illnesses’ which are therefore uncontrollable and comparable to alcoholism or drug addiction. Child molesters and murderers are thus depicted as poor ‘patients’ who are not responsible for their ‘sick’ behavior.
Objective, medical diagnostic tests measure chemical and physical changes in tissues; they do not evaluate or judge ideas or behaviors. Before there were sophisticated diagnostic tests, physicians had a hard time distinguishing between real epilepsy—that is to say, neurological seizures—and what we call ‘hysterical seizures,’ which is simply faking epilepsy, pretending to have a seizure. When epilepsy became understood as due to an increased excitability of some area of the brain, then it ceased to be Psychopathology or mental illness, and became neuropathology or brain disease. It then becomes a part of neurology. Epilepsy still exists. Neurosyphilis, though very rare, still exists, and is not treated by psychiatrists; it is treated by specialists in infectious diseases, because it’s an infection of the brain.
I am bitterly opposed to all of these autocratic medicalizations. All of these glorify the punitive state and the punitive doctor and debase the citizen for exercising his free choice. It’s as simple as that.